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  • Top Tips for Involving Fathers in Maternity Care

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    Top Tips for Involving Fathers in Maternity Care

    Compared with past generations, societys expectations are increasingly for fathers to play a full role throughout pregnancy, labour, childbirth and in the postnatal period. Most expectant mothers want their partners to be involved and this desire is also shared by most expectant fathers. There is also substantial evidence about health and wellbeing benefits that result from fathers being involved in their partners maternity care.

    Promoting a cultural shift throughout healthcare provision to include fathers in all aspects of a childs wellbeing is needed. NHS policy is to increase engagement with and encourage fathers involvement in maternity care in order to improve overall family support.

    Background and policy contextOver the last decade there has been a national drive towards increased recognition of the fathers role and encouraging fathers involvement in health care in general, particularly in maternity services. In 2004 the National Service Framework for Children, Young People and Maternity Services supported a cultural shift in all service provision to include fathers in all aspects of a childs wellbeing. Since then NICE has produced guidelines around the provision of information and support for parents in the postnatal period, the

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    Department of Health recommended services work together to equip mothers and fathers for parenthood in Maternity Matters: Choice, access and continuity of care in a safe service; and the Department for Children, Schools and Families (Department for Education as it now is) acknowledged the need to involve fathers in a number of key policy documents.

    The new administration takes this issue no less seriously. On 18 July, the Government published Families in the Foundation Years and Supporting Families in the Foundation Years. Together these publications set out the Governments vision for foundation years and the services that should be offered to all parents and families from pregnancy to age five. These make clear that from pregnancy onwards, all professionals should consider the needs and perspective of both parents. All those involved in working with families have a role to play in setting the right tone and expectations, and helping professionals to think about how better to engage fathers in all aspects of their childs care, development and the decisions affecting their child.

    Benefits of involving fathers in maternity careWomen engage frequently with the NHS during pregnancy and childrens early years, providing opportunities for health promotion and education. General healthy lifestyle advice on issues such as diet and nutrition, breastfeeding and smoking are focused on the expectant mother. However, these lifestyle choices also concern the expectant fathers and services should take the opportunity to target both parents to have the best effect. At the East Cheshire NHS Trust for example, they have implemented joint referrals for a couple to attend smoking cessation services, which increases the likelihood of both expectant parents quitting smoking.

    Many fathers feel stressed and anxious about pregnancy, birth and becoming a father. By involving fathers in antenatal consultations and parent education classes/programmes this will help to alleviate some of this anxiety and prepare them for childbirth and fatherhood. There is also evidence that early involvement has a major impact on the future relationship of father and child.

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    Top Tips for Involving Fathers in Maternity Care

    A well prepared father has a positive effect on his partner. Women who have the support of a partner during labour require less pain relief and feel more positive about the birth. Teaching massage and relaxation techniques to fathers to use during labour can help to increase marital satisfaction and decrease postnatal depressive symptoms, as well as providing psychosocial support for women. Immediately after being born by caesarean section giving a baby to their father has resulted in the baby being calmed and more likely to stop crying.

    Barriers to fathers becoming engaged in maternity careDespite evidence that the involvement of fathers during pregnancy, birth and the postnatal period can positively affect the health and wellbeing of mothers, babies and their families, the way maternity care is commonly organised in the UK tends to generate feelings of exclusion, fear and uncertainty.

    Many fathers experience their place in maternity care as being not-patient and not-visitor. The perceptions of being both uninformed and unwelcomed or excluded are recurring themes in studies relating to expectant fathers relationship with maternity services.

    Women who have the support of a partner during labour require less pain relief

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    Fathers come from a range of backgrounds, ethnic groups, and ages; their individual needs will need to be assessed and the differing roles they play within different communities recognised and addressed. Appropriate and culturally competent preparation for childbirth and fatherhood has the potential to enhance maternal and child health and have positive impacts on families in general.

    Changing maternity systems to engage with fathersThere are variations in clinical practice and considerations concerning confidentiality, culture and companionship which will impact on how maternity staff and maternity services involve and support fathers. However, maternity systems need to ensure that they are designed to engage and support fathers.

    All professionals involved in the delivery of maternity care will encounter opportunities to engage with and support fathers in both primary and secondary care settings. However, as midwives have the most routine contact with fathers, they are ideally placed to help advise fathers on how to support their partner during pregnancy, birth and caring for their newborn baby.

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    Top Tips for Involving Fathers in Maternity Care

    In general, expectant fathers are keen to know precisely what they should do to get it right. Taking time to give relevant information and to engage with the father in all aspects of care can help to foster greater engagement and satisfaction for both parents. While many fathers who attend antenatal education classes/programmes have reported feeling engaged, they also felt that although welcomed, they were excluded by their content. While they recognise the need for these antenatal education classes/programmes to be woman focussed, they would like some specific time and information allocated for them. Men also want antenatal education programmes to provide more information on postnatal issues.

    It is also important to ensure fathers from all backgrounds feel involved from an early stage. In Hull for example, a Teenage Pregnancy Support Service assesses young fathers needs as well as young mothers. Young fathers have been given help and advice to sort out housing and benefits issues, and support to develop parenting skills. Expectant fathers who are still at school have been supported in telling their parents about the pregnancy and the service also liaises with schools in Hull to enable the expectant father to attend some ante-natal appointments and parenting education classes.

    In University Hospital of North Staffordshire NHS Trust time is spent preparing expectant fathers so they can have an active role during birth. Antenatal education classes are available on Sunday afternoons and evenings to fit round working lives and football fixtures. More women are now managing to cope at home with their partners support.

    It is key that expectant fathers feel welcomed at the birth of their baby. For example, referring to him by his preferred name will help make him feel more welcome. In North Staffordshire, visiting times are now more flexible (9am till 9pm) to help fathers balance their work and family commitments. Provision of refreshments and an allocated toilet for fathers to use has made things a lot easier. These small changes are helping fathers to support their partner and bond with their baby. Initially, there were concerns from staff that having the fathers on the ward for 12 hours a day would put additional stress on the busy unit. However it has eased the workload of the midwives because mothers are calling them less as they have their partners to help them.

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    The Partners Staying Overnight pilot at the Princess Anne Wing of the Royal United Hospital in Bath (managed by the Great Western Hospitals NHS Foundation Trust is a good example of how a maternity unit can involve fathers in the early postnatal period. The scheme has been introduced in response to the needs of women who give birth either at night or during the early hours of the morning and want support and care from their partners. This scheme encourages new fathers to bond with their infant and to be a visible parent. It also reduces the workload of midwives as the father can help his partner.

    Similarly, facilities at the Diana, Princess of Wales Hospital in Grimsby have been designed so as to enable fathers to stay with their partners after the birth so that they can share in the first few hours and days as they become parents together. In recognition of their efforts, the maternity team was awarded the All Party Parliamentary Group on Maternity 2011 award for Most inclusive maternity service for new fathers.

    Post-traumatic stress can occur in fathers and this can have serious consequences for family relationships. Expectant fathers are often forgotten when an emergency section is required and they can be left feeling unsure about what they are allowed to do and what their role is. Better methods for identifying men with post